Active NPI
Leslie Jacob
- Speech-Language Pathologist
- Forney, TX
National Provider Identifier
1740971696
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 112047
- Practice address
- 256 Van Buren Dr
Forney, TX 75126-5275 - Phone
- (405) 519-0734
- NPI assigned
- May 19, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 112047 | TX | Primary |
Addresses
Primary practice location
256 Van Buren Dr
Forney, TX 75126-5275
Mailing address
256 Van Buren Dr
Forney, TX 75126-5275
Phone (405) 519-0734
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1684454400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1684454400000",
"number": "1740971696",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "256 VAN BUREN DR",
"city": "FORNEY",
"state": "TX",
"postal_code": "751265275",
"telephone_number": "405-519-0734"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "256 VAN BUREN DR",
"city": "FORNEY",
"state": "TX",
"postal_code": "751265275",
"telephone_number": "405-519-0734"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACOB",
"first_name": "LESLIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-05-19",
"last_updated": "2023-05-19",
"certification_date": "2023-05-19",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "TX",
"license": "112047",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Forney, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.